Objective:

To evaluate the duration and efficiency of hepatic surveillance needed after initial treatment for uveal melanoma.

Key Findings:

• 29% of patients developed liver metastases, with 93% detected within the first five years, highlighting the efficiency of early surveillance.
• The median time from diagnosis to liver metastasis was 1 year and 11 months, indicating a critical window for monitoring.
• Only 23 additional cases of metastasis were identified between years six to eleven, reinforcing the diminishing returns of prolonged surveillance.
• Surveillance efficiency diminishes significantly after five years, suggesting a need for protocol reevaluation.

Interpretation:

The findings suggest that prolonged routine imaging beyond five years may be inefficient, advocating for personalized surveillance protocols based on individual risk factors such as T stage and tumor location.

Limitations:

• The study is retrospective and may not account for all variables influencing metastasis, potentially skewing results.
• Late metastases occurred in lower-risk groups, complicating surveillance decisions and indicating the need for a nuanced approach.

Conclusion:

Current surveillance protocols should be re-evaluated to focus on personalized strategies based on tumor characteristics and risk factors rather than a uniform approach.